Detecting Mild Cognitive Deficits in <scp>P</scp>arkinson's <scp>D</scp>isease: <scp>C</scp>omparison of <scp>N</scp>europsychological <scp>T</scp>ests

Hoogland, Jeroen; Wanrooij, Lennard L. van; Boel, Judith A.; Goldman, Jennifer G.; Stebbins, Glenn T.; Dalrymple‐Alford, John C.; Marras, Connie; Adler, Charles H.; Junqué, Carme; Pedersen, Kenn Freddy; Mollenhauer, Brit; Zabetian, Cyrus P.; Eslinger, Paul J.; Lewis, Simon J.G.; Wu, Ruey‐Meei; Klein, Martin; Rodriguez-Oroz, María C.; Cammisuli, Davide Maria; Barone, Paolo; Biundo, Roberta; Bie, Rob M.A. de; Schmand, Ben; Tröster, Alexander I.; Burn, David J.; Litvan, Irene; Filoteo, J. Vincent; Geurtsen, Gert J.; Weintraub, Daniel

doi:10.1002/mds.110

Cited by 49 publications

(39 citation statements)

References 38 publications

(46 reference statements)

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“…It is reasonable to assume that cultural bias on testing has a similar impact on MCI and dementia in PD. To our knowledge, there are no studies other than ours addressing this directly, however, a recent study aimed at identifying tests that consistently detect cognitive decline in PD is particularly relevant (Hoogland et al, 2018). Neuropsychological data of 2,908 non-demented PD patients from 20 international studies and nine countries (USA, Canada, New Zealand, Australia, Spain, Italy, Netherland, Germany, and Taiwan) were pooled, and although the cognitive domains affected were consistent with the PD literature (memory, executive dysfunction and attention), no specific tests were recommended due to high between-study variability.…”

Section: Discussionmentioning

confidence: 97%

Origins Matter: Culture Impacts Cognitive Testing in Parkinson’s Disease

Statucka

Cohn

2019

Front. Hum. Neurosci.

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Cognitive decline is common in Parkinson’s disease (PD), and precise cognitive assessment is important for diagnosis, prognosis, and treatment. To date, there are no studies in PD investigating cultural bias on neuropsychological tests. Clinical practice in multicultural societies such as, Toronto Canada where nearly half of the population is comprised of first generation immigrants, presents important challenges as most neuropsychological tools were developed in Anglosphere cultures (e.g., USA, UK) and normed in more homogeneous groups. We examine total scores and rates of deficits on tests of visuoperceptual/visuospatial, attention, memory, and executive functions in Canadians with PD born in Anglosphere countries ( n = 248) vs. in Canadians with PD born in other regions (International group; n = 167). The International group shows lower scores and greater rates of deficits on all visuoperceptual and some executive function tasks, but not on attention or memory measures. These biases are not explained by demographic and clinical variables as groups were comparable. Age at immigration, years in Canada, and English proficiency also do not account for the observed biases. In contrast, group differences are strongly mediated by the Historical Index of Human Development of the participants’ country of birth, which reflects economic, health, and educational potential of a country at the time of birth. In sum, our findings demonstrate lasting biases on neuropsychological tests despite significant exposure to, and participation in, Canadian culture. These biases are most striking on visuoperceptual measures and non-verbal executive tasks which many clinicians still considered to be “culture-fair” despite the growing evidence from the field of cross-cultural neuropsychology to the contrary. Our findings also illustrate that socio-development context captures important aspects of culture that relate to cognition, and have important implications for clinical practice.

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Section: Discussionmentioning

confidence: 97%

Origins Matter: Culture Impacts Cognitive Testing in Parkinson’s Disease

Statucka

Cohn

2019

Front. Hum. Neurosci.

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“…confidence in) lower scores in particular may not be equivalent across measures 71 . The large between-study variability when neuropsychological measures have been used to characterise cognition in PD relative to published norms in the absence of local norms also suggests caution when making comparisons for similar tests across different sites 72 . A second limitation is that our findings may be test and site-specific.…”

Section: Discussionmentioning

confidence: 99%

Cognitive tests that identify high risk of conversion to dementia in Parkinson’s disease

Myall

Horne

MacAskill

et al. 2020

Preprint

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Background:People with Parkinson's disease who meet criteria for mild cognitive impairment are at increased risk of dementia. It is not known which tests are more effective than others for identifying the risk of dementia. Methods: At baseline, we assessed performance on 21 neuropsychological test measures spanning five cognitive domains in a prospective longitudinal study of 196 non-demented people with Parkinson's. Elastic net logistic regression was used to identify a pair of tests from each cognitive domain that best predicted conversion to dementia over a four year period. The optimal tests most predictive of dementia were also determined when mild cognitive impairment was derived from a logistic-regression classifier that used all 21 measures simultaneously. Results: With two tests per domain, the resulting mild cognitive impairment group (N=87/196) captured 44 of 51 individuals who converted to PDD; the out-of-sample relative risk of PDD was 8.0 (95% CI [4.3,24]), similar to that achieved with the full battery (N=102/196, capturing 45/51, relative risk = 6.9). When selecting tests regardless of domain, there was strong evidence for three tests: Trail Making part B (Executive), Map Search (Attention), and CVLT-II word list acquisition (Episodic Memory). The logistic-regression classifier achieved an out-of-sample AUC of 0.90 [0.84, 0.96] and a relative risk of 12 [6,39]. Conclusions: An abbreviated selection of neuropsychological tests can identify non-demented patients who have a high relative risk of progression to PDD.

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“…Up to 83% of patients, conditional on survival, will develop dementia within 20 years of onset (Hely, Reid, Adena, Halliday, & Morris, 2008). The biggest risk of progression to dementia is meeting criteria for PD with mild cognitive impairment (PD-MCI) (Hoogland et al, 2018;Wood et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Microstructural integrity of the major nuclei of the thalamus in Parkinson’s disease

Borlase

Myall

Melzer

et al. 2020

Preprint

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Background: Previous research has shown an association between thalamus and cognition inParkinson's disease (PD).Objectives: To investigate the microstructural integrity of the nuclei of the thalamus and relationship with cognition. Methods: Level II Movement Disorder Society Task Force Criteria characterised patients withParkinson's disease as cognitively normal (PDN, n=51); with mild cognitive impairment (PD-MCI, n=16) or with dementia (PDD, n=15). Twenty-three healthy control subjects were included for comparison. A k-means clustering approach segmented the thalamus into regions representing nine major nuclei. Volume, fractional anisotropy and mean diffusivity of nuclei were compared between cognitive groups and the relationship with cognitive domain z-scores investigated using hierarchical Bayesian regression models. Results:There was an overall progressive increase in mean diffusivity as cognition deteriorated (PDN: 1.4 µm 2 /s (95% uncertainty interval [0.2, 2.7]), PDMCI: 2.4 µm 2 /s [0.8,4.0], PDD: 4.5 µm 2 /s [2.8, 6.3]). The largest increase was in the lateral dorsal nucleus (PDN: 0.3 µm 2 /s [-6.7, 7.2], PDMCI: 5.4 µm 2 /s [-4.7, 16.1], PDD: 14.8 µm 2 /s [5.0, 25.0]). Fractional anisotropy showed minimal change between cognitive groups (PDN: 0.001 [-0.005, 0,007], PDMCI: -0.005 [-0.013, 0.003], PDD: -0.005 [-0.014, 0.003]). Increase in mean diffusivity of the thalamus is associated with a global decline in cognition, the magnitude of the effect was greatest in lateral dorsal nucleus. Fractional anisotropy only showed evidence of a relationship with cognitive domain scores in the lateral dorsal nucleus. Conclusions:The relationship between lateral dorsal nucleus integrity and cognitive changes is likely due to its primary connectivity with frontal and temporal regions.

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Detecting Mild Cognitive Deficits in Parkinson's Disease: Comparison of Neuropsychological Tests

Cited by 49 publications

References 38 publications

Origins Matter: Culture Impacts Cognitive Testing in Parkinson’s Disease

Origins Matter: Culture Impacts Cognitive Testing in Parkinson’s Disease

Cognitive tests that identify high risk of conversion to dementia in Parkinson’s disease

Microstructural integrity of the major nuclei of the thalamus in Parkinson’s disease

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